Cardac Events in Psoriasis

Posted by Elaine Moore Dec 23, 2008

Recent studies show that people diagnosed with psoriasis may be at greater risk for developing heart disease. In patients with severe psoriasis who are younger than 50 years old, the risk is comparable to that seen in diabetes. In patients of all ages with psoriasis the risk for heart disease was higher than that seen in the general population, but in younger people with severe disease the risk was significantly higher.

One recent study conducted at the University of Pennsylvania School of Medicine confirmed earlier studies showing this link while controlling for age, gender, smoking, elevated cholesterol, and other risk factors. Several studies show that patients with psoriasis often have key components seen in metabolic syndrome, including hypertension, obesity, elevated lipids, and insulin resistance. Furthermore, the inflammatory process in psoriasis is similar to the inflammatory process that occurs in atherosclerosis, a condition commonly referred to as hardening of the arteries. Both conditions are associated with elevated levels of the inflammatory blood marker C-Reactive Protein (CRP).

Inflammation as the Culprit

Earlier studies from the Karolina Institute have shown a higher risk for heart disease in patients with rheumatoid arthritis and systemic lupus erythematosus. The common link, researchers believe, is the underlying inflammation. Inflammation is the immune system's response to injury in infection. In patients with psoriasis and other autoimmune disorders, the immune system persists in launching this inflammatory response. Chronic inflammation allows cholesterol and other cellular debris to build up forming plaques in the arteries.

Studies show that patients with psoriasis, particularly men, use alcohol and smoking as a form of self-medication to reduce the emotional consequences of psoriasis. Studies show an increased mortality in patients with psoriasis, attributed to heavy drinking. Smoking has also been cited as a major risk factor in psoriasis, particularly for pustular psoriasis. Severe psoriasis is also known to cause folate deficiency, which is linked to high levels of homocysteine. Elevated homocysteine levels are an additional risk factor for heart disease.

The fact that psoriasis is linked to high risk for heart disease suggests that psoriasis is a systemic inflammatory disorder. Researchers at Mayo Clinic report that the benefit of these studies is that younger patients can now monitor their other factors for heart disease and reduce known risk factors. Whether conventional treatments for psoriasis can reduce this increased risk of heart disease is not yet known.

Fish Oil as a Solution

Fish oil supplements have been suggested as a treatment for persistent inflammation. Fish oil supplements are now FDA approved for the treatment of lipid disorders, and available in prescription form as well as over the counter preparations. The EPA and DHA omega-3 components of fish work like aspirin, preventing platelets from adhering together and promoting clot formation. In this way, like aspirin, fish oils reduce the risk of heart attack

Resources

Rick Ansorge, Psoriasis May Up Risk of Heart Attack, WebMD Health, Oct 10, 2006, Medscape News Article

Evidence that People with Psoriasis Have Greater Risk For Developing Heart Disease Than General Population, Dermatology News, November 13, 2006.

Fishing for Answers, Foundations of Wellness, UC Berkeley Wellness Letter.

Moira Petty, Daily Mail, Psoriasis linked to heart disease, October 25, 2005.